Several conditions, such as diabetes, high blood pressure, smoking, obesity, can cause chronic kidney disease. End-Stage Renal Disease (ESRD) is the stage of advanced chronic kidney disease (CKD) characterized by the irreversible loss of kidney function and requires regular dialysis treatment or kidney transplantation to sustain life. The two main causes of CKD are diabetes and high blood pressure. Globally, these two conditions were the primary diagnosis in 75% of kidney failure cases between 2015 and 2017.
Around 47% of new ESRD patients had a primary diagnosis of diabetes, the leading cause of ESRD, while 29% of new ESKD patients had a primary diagnosis of hypertension, the second leading cause of ESRD. Other conditions that can lead to ESRD are glomerulonephritis (diseases that damage the kidney's filtering units), which are the third most common type of CKD; inherited diseases, such as polycystic kidney disease; malformations at birth that occur as a fetus develops; lupus and other immune diseases; obstructions such as kidney stones or an enlarged prostate; and repeated urinary tract infections.
At a global level, the number of patients with treated kidney failure is expected to increase from 2.6 million in 2010 to 5.4 million in 2030. Also, data from the World Population Prospects projects that, by 2050, nearly all regions in the world will have a quarter or more of the population aged 60 and above. Chronic kidney disease (CKD) has a high global prevalence (~13%) worldwide, and the prevalence of chronic kidney disease and end-stage kidney disease increase with age. There are currently only two methods for treating ESRD—dialysis and kidney transplantation, but due to the shortage of kidney organs for transplantation and rising waiting lists, dialysis is preferred. Hence, a rise in dialysis centers is observed to occupy the increasing number of patients coming for dialysis.
Dialysis center planning is now easy by public data networks that track nearly every dialysis patient in the nation. In 2019, most dialysis patients were treated in ~45,600 dialysis centers worldwide, with an average of more than 75 patients per-center. However, this figure varies considerably from country to country. For instance:
- In Senegal (Africa), the number of patients with CKD on dialysis has grown from 50 in 2010 to more than 800 in 2018. This number was doubled in 2019 with the opening of ten new hemodialysis centers across the country. Two new peritoneal dialysis centers were opened in 2019.
- Argentina has dialysis units in both hospital and private settings. There are a total number of 597 dialysis centers in the country. 11% (68 centers) of these centers are government-owned, 377 (63%) are independent dialysis centers, and foreign dialysis companies own the rest (152 centers; 26%) as per 2020 published article.
- As per the 2018 magazine, Fresenius Medical Care AG & Co. KGaA (Germany) intends to open another 100 renal hospitals and dialysis centers in China over the next five years. In December 2017, the company launched its first independent dialysis center in China.
- According to 2018 data, the new hospital construction has slowed; there has been a surge in the development of dialysis centers in the U.S. The Illinois Health Facilities & Services Review Board in June 2018 received nine proposals for dialysis centers. Kidney Care Center, a consortium of 30 nephrologists based in Joliet, got approval in June to build a 14-station, $1.5 million dialysis center on the west side of Elgin (U.S.). In June 2018, DaVita Inc. (U.S.) got approval to build renal centers in Woodridge, Villa Park, and Chicago's Auburn Park neighborhood. In 2018, DaVita’s overall network of U.S. outpatient dialysis centers increased by 154 dialysis centers, primarily due to opening new dialysis centers and from acquisitions of existing dialysis centers.
- In Malaysia, citizens can access the MOH's subsidized dialysis services at university hospitals, Ministry of Defense hospitals, and local authorities. These measures combined have resulted in expanded coverage of stand-alone dialysis centers, with the number of dialysis centers across Malaysia increasing from 205 in 2000 to 758 in 2014 and further increasing.
- In 2018, Fresenius Medical Care AG & Co. KGaA (Germany), in collaboration with Sri Ramakrishna Hospital, announced the inauguration of a new dialysis center of excellence at Coimbatore, Tamil Nadu state in India. The Indian Government, in its Healthcare Union Budget 2016, announced the plan for stand-alone HD centers for patients with ESRD. The number of centers providing hemodialysis increased from 50 in 2008–2009 to 89 in 2011– 2012 in India. Overall, the number of patients who received hemodialysis for ESKD increased from 29.5 per million of the population in 2008–2009 to 122.2 per million of the population in 2011–2012.
- The total number of active dialysis centers in Brazil increased by 37.8% from 550 in 2002 to 758 in 2017. The number of dialysis centers has progressively increased in the country, reaching 781 in 2018, distributed mainly in the southeast (47%), south (20%), and northeast regions (18%); only 6% were in the north region. Dialysis centers were mainly private (72%).
Thus, the increasing number of dialysis centers will lead to a rise in the installation of dialysis machines, with the increased use of dialyzers and other consumables. This is expected to drive the hemodialysis and peritoneal dialysis market at a CAGR of 4.4% to reach $17.69 billion by 2027, according to Meticulous Research®.
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